Good Evening,

This briefing provides an overview of current proposals (as of 1 June 2020) on the crucial role of upper-tier councils in supporting the NHS Test and Trace Service, with an expectation that districts and counties will work closely on these issues e.g. with the role of environmental health. These proposals will be further developed to reflect the learning and feedback from the experience of the 11 groups of authorities already working on their Local Outbreak Control Plans, linking to the role of the National Advisory Board, chaired by the chairman of the Local Government Association, James Jamieson. The board is meeting weekly during this important stage. Our intention is to update this briefing as councils’ role in supporting the service is finalised in the coming weeks.

**The NHS Test and Trace Service – how it works**

Launched last week, this service is designed to control the rate of reproduction of Covid-19 by reducing the spread of the infection. This will allow greater easing of the social distancing measures that have been in place since the lockdown was introduced in a way that is safe and will protect lives.

The core of the system relies on self-reporting by the public. When they experience symptoms they are required to self-isolate for seven days, but will be able to order a test on-line or by calling 119. If they test positive they will be contacted by the NHS Test and Trace Service, which will ask about their symptoms, ask if they have family or other people living with them, ask if they need support in self-isolating, ask for the name and contact details of anyone outside their household they have been in close contact with in the two days before their symptoms started, and if they work in or have recently visited a setting with other people (such as a school, workplace or GP’s surgery).

The NHS Test and Trace Service will then trace close recent contacts of anyone who has tested positive for Covid-19, and if necessary notify them that they must self-isolate. The Service will ask if they are experiencing any Covid-19 symptoms, and provide advice on what the close contact must now do as they have been in contact with someone who has tested positive for Covid-19.

When it is launched, the NHS Covid-19 app is designed to supplement the core elements of the Test and Trace service by increasing its speed and reach, especially for those who have been in close contact with someone who has tested positive but are not known to them, for example on public transport.

It is anticipated that most people will be able to self-isolate for the maximum two week period without any support. However, where someone who has been advised to self-isolate needs practical or social support for themselves, or support for someone they care for, they will be directed to their council for help with things like food or medicine deliveries. In many instances this may be the extent of councils’ role in supporting people who use the NHS Test and Trace Service.

Where the contact tracing process identifies a complex case or one involving a high-risk location, such as where a person who has tested positive for Covid-19 has worked in or recently visited a health or care setting, a prison or other secure setting, a school or critical national infrastructure, then the case will be referred to Public Health England’s regional teams and the relevant council’s Public Health teams to deal with. These teams have worked in this way for many years and have tried and tested ways to deal with such complex cases. Local public health teams are already implementing plans to deal with outbreaks in settings such as care homes and prisons, and NHS Trusts are similarly doing so with Public Health England in hospitals. Local Outbreak Control Plans

Local Outbreak Control Plans are designed to clarify how local government works with the NHS Test and Trace service, so that the whole local system is geared up to contain the virus. There are three important elements of governance:

1. Leading the public health response locally at an Upper Tier LA level through Directors of Public Health and Health Protection Boards, working closely with Public Health England. DPHs will be responsible for producing the plans as they hold the statutory responsibility for public health;
2. Managing the deployment of broader resources and local testing capacity to swiftly test local people in the event of an outbreak and liaising with the Joint Biosecurity Centre. This will be done by Chief Executives working through local emergency planning structures and Local Resilience Forums; and
3. Providing political oversight of the local delivery of plans, and communicating and engaging with residents and communities through a member-led Board. This can be a new or existing forum such as a Health and Wellbeing Board or Covid Recovery Board.

The plans are now being developed and the ambition is to have good plans in place across England by the end of June. There is flexibility in the above arrangements to allow councils to collaborate on different geographic footprints to bring this work together, for example working with Mayoral Combined Authorities.

Leading the local public health response

The local public health response will build on existing health protection good practice, with a C-19 Health Protection Board put in place appropriate for this pandemic. Working in partnership with the full range of partners, such as PHE, NHS and the voluntary sector, the plans will set out how vulnerable people are being supported to self-isolate, as well as plans to manage complex cases in high-risk places, locations and communities, in particular care homes and schools.

Within these plans councils will need to consider what preventative measures are required, how the situation in schools and care homes are monitored, possible scenarios and what strategies are needed to manage an outbreak in these settings (such as temporary closures to allow the deep cleaning of facilities). As part of their local response, councils will be able to draw on the expertise and support of Public Health England’s regional teams.

Managing the deployment of broader resourcing, local testing capacity and liaising with the Joint Biosecurity Centre

Where appropriate councils may need to arrange for the rapid deployment of mobile testing units to assist in the management of a local outbreak. A response of this or a similar nature may require activity across a range of local partners, and existing Gold command forums will provide the means of coordinating that action. Alongside this councils will need to work closely with the Joint Biosecurity Centre, which has the role of bringing together data from testing and contact tracing, alongside other NHS and public data, to provide insight into local and national patterns of transmission and potential high-risk locations and to identify early potential outbreaks so action can be taken. The Joint Biosecurity Centre will shortly be issuing further information about how local movement restrictions may need to be increased if infections increase again.

Providing political oversight of local delivery of the Test and Trace Service and keeping local residents informed As part of their local plans councils are expected to have a member led, typically by the Leader of the authority, Local Outbreak Control Board, or use some existing forum such as the Health and Wellbeing Board for this purpose. These arrangements will be expected to provide political oversight of local delivery of the Test and Trace Service, will lead the engagement with local communities and be the public face of the local response in the event of an outbreak.

This Week’s update

An update about activity in the last week is below:

- **Local outbreak plans are** increasingly understood nationally as a way to build on our strong public health expertise of the DsPH, enhanced to put in place C-19 Health Protection Boards so that there is broader support for this particular pandemic, with support from the local Strategic Coordination Group and political oversight recognising that public engagement and trust is crucial to keep the R rate down. The seven themes of the local outbreak plan (Care homes and schools, high risk settings, testing deployment, tracing capacity, data, self isolation support and governance) are increasingly understood, along with the connection to the role of the Joint Biosecurity Centre to support that local activity.

- **Launch of NHS Test and Trace system**, with briefings for all councils last week – we are working on the FAQ to send later this week, with the next CXs/DsPH briefing planned for w/c 8 June.

- **Meeting of the Local Outbreak Plan National Advisory Board**, including the Minister of State, discussed issues of escalation and governance, especially given some of the media coverage last week and commissioned further work to increase clarity. This has met twice and will continue to meet weekly.

- **Meeting of the 11 groups of “good practice councils” for local outbreak planning** – who are working with a range of other councils on the early design work. Main issues – data and data flows; governance and relationship with Joint Biosecurity Centre; and who works on what themes to help the sector as a whole. These councils are engaging a broader range of councils in the endeavour to share best practice and solve emerging policy and practice issues.

- **Funding** – with the announcement of £300m last week, work continues on the allocation of that funding, which will hopefully be resolved later this week

- **Stakeholder engagement** – important conversations with a range of people to help develop local outbreak plans, including ADPH, NHS ICS colleagues, LRF chairs, with representative business organisations and voluntary/faith organisations planned

- **An ADPH update from Jeanelle De Gruchy** last week provided information about data flows, thanked colleagues for the returns on resourcing, and provide feedback from the Design Working Group as part of the sector-led improvement approach.

- **A PHE/ADPH update** from Richard Gleave containing a near final version of the Guiding Principles for DsPHs for this phase of C-19 work and crucial data to inform the local effort

- **Local Test Sites** – pilots underway, in coordination with local council and more planned. Leeds open, Manchester, London, Newcastle and Birmingham all planned

- **New Regional Test Sites** – continuing to build new fixed sites but have changed the process to ensure that local authorities fully involved in selection of site

- **Vulnerable groups and testing** - piloting access to vulnerable groups with Bradford, Oldham, Brent and Newham before expanding this across the country

- **Homeless testing** - planning pilots in Manchester, London and Wiltshire. Exploring pilots in a two tier areas

- **Increased access to tests** - developing plans to use GP surgeries and pharmacies as a means of distributing tests • **Improved performance on testing results** – with more recent results showing more than 90% within 48 hours

• **Mobile Test Units** - building more mobile testing units so that each upper tier LA can task one in their area. Piloting local direction of mobile testing units with North Yorkshire and Gloucestershire to help develop best approaches for local deployment.

• **Outbreak plans in practice** – the response in Weston shows how testing and tracing can support LAs in the delivery of their outbreak plans, with data coming through from PHE, rapid access to testing sites with no requirement for booking, and redeployment of a mobile unit to the optimum site.

• **Data** – progress with data from pillar 2 testing; more data to be available from PHE to local Public Health teams, for example on complex situations including daily activity reports on the number of cases and contacts reported; and weekly epidemiological and performance reports.

I hope this is helpful. Thank you for the work that you are doing and keep feeding your questions through. The next update will include some frequently asked questions.

Best wishes,

**Tom Riordan CBE**